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High fiber for diabetics.

Now early 20 years as a medical A T doctor in East Africa left Dr. Denis Burkitt totally convinced of the health benefits of a high-fiber diet. He had been a general surgeon in remote areas of several African nations from 1948 to 1966. After returning to his native England, he saw many health problems that didn't exist in Africa. It was then that he began to reflect on these obvious disparities.

Gallstone surgeries in Africa? Dr. Burkitt removed only two gallbladders in all of his years as a surgeon in that country. One was from an African queen-who could afford the luxury of a diet of imported rich delicacies.

Colon cancer? Dr. Burkitt can remember only twice operating for this affliction, so common in Europe and America.

Diverticulitis? Never heard of it.

Hiatus hernia? Dr. Burkitt commented, "A friend of mine who, for eight years, was the only thoracic surgeon for a population of 6 million people never found a single case of hiatus hernia in an African."

Heart attacks? Virtually unknown.

"I believe that fiber protects against all these diseases," Dr. Burkitt explained. "Of course, a high-fat diet with smoking would be an important risk factor in things like coronary heart disease. But fiber, we believe, is protective in some measure against them all."

We brought up the topic of diabetes to Dr. Burkitt. He was well-prepared: "Everyone used to say, Oh, diabetes is due to genetics. You can get mice to all have diabetes.' Yes, there is a genetic element, but the genes only cause the disease in a certain environment. We can alter our environment, but we can't alter our genes.

"As an example of this, there's a little island in the Pacific, way out east of Bomeo, called Nauru. The queen [of Britain] visited it a few years ago, so it came up on our television. We happen to know, fortunately, that in the early 1950s there was hardly any diabetes here, as in the other Pacific islands. And incidentally, you see, no wild animal ever gets diabetes. Hunter-gatherer populations don't get diabetes. This disease is one of the first diseases that comes after you begin the clever Western diet.

"Now came the discovery that this island was covered with phosphates from bird droppings over several thousand years, and phosphates sell for a lot of money as they make very good fertilizers. So they virtually scraped the top off the island and sold it. Got so much money that today they are the second wealthiest people in the world [$34,000 a year per person] after the Arabs in the Middle East.

"So they said, See what clever guys those are in the United States. They've got television, and they've got hi-fi radios, and they've got motorcars. Surely, they must be the cleverest people on earth. Therefore, they must know what to eat. And if we follow their eating habits, we'll be great people too.'

"So they gave up eating the island food they had traditionally adopted. And instead they began importing hamburgers, cola drinks, French fries, and what have you.

"Now, 20 years or so later, over 40 percent of the entire population of Nauru over the age of 20, male and female, are diabetics," Dr. Burkitt commented.

"That's just one example to show they have plunged within one generation into an environment to which they are not adapted. They're learning obesity, they'll get their gallstones and their coronary heart disease within 30 years, and people might say to them, Well, you aren't adapted; let's wait until you adapt.' But that might take another 10,000 years, so it's not going to help any of them.

"We, ourselves, have changed our lifestyle more in the last 150 years than almost throughout our life history," Dr. Burkitt continued. "And if only one would go back a bit in history. I don't mean giving up all its food technology-it is all good-but in general proportion of food, going back to what Americans did in the second half of the last century, before they even learned about coronary heart disease, diverticular disease, bowel cancer, and all of those problems. I think that would be prudent.

"I think we might find we made mistakes, but all the evidence available suggests that, without having an uncomfortable diet-or without being a martyr-we can still eat for enjoyment. We don't always have to stick to a diet.

"In the history of medicine," Dr. Burkitt pointed out, "we haven't waited to understand mechanisms before taking action. Everybody who does epidemiology knows about the cholera epidemic in England 150 years or so ago where a Dr. Snow plotted all the cases of cholera on a map and asked himself what might be the common factor of all the people who have cholera. He found they all drew water from the same pump and that that pump took water from the Thames below where the sewage went in. So he said perhaps it's due to bad water.

"He didn't know any more than that but said to the parish council, Will you please give me permission to take the handle off the pump?' When he took the handle off the pump, the cholera epidemic subsided. So people decided it is bad to drink sewage contaminated water. They didn't know why. It wasn't until a long time later that they discovered the organisms, the vibrio that was causing cholera.

"A lot of the pseudoscientists today would say, uh-uh, we mustn't follow Snow's work until we find out exactly what it is all due to and how it works. You've got to do the research work, but if you have enough evidence on something, you take action before you understand it. I don't remotely understand electricity or how electric bulbs work, but when I go into a room I turn the switch on and it's fine. I don't have to wait until I understand all about electricity before I use it."

Dr. Burkitt is by no means alone in his evaluation of fiber in the fight against diabetes. Years of research by Dr. James Anderson, a professor of medicine and clinical nutrition at the University of Kentucky Medical Colege, have firmly established that a diet high in fiber can reduce the insulin requirement of some diabetics and has been known to eliminate it completely in some Type 11 diabetics.

"Over the last century there was a gradual change in the diet of the average American. We began eating more fat and cholesterol as well as more refined sugars than our great-grandparents did," Dr. Anderson said. "We should eat more unrefined starch from potatoes, beans, and whole grains. Much of the beneficial fiber is stripped from our flour before it reaches the table." He added that many experts think these changes in diet are largely responsible for the present epidemic of heart attacks, strokes, hardening of the arteries, and diabetes.

"American diabetics have five times more heart attacks and strokes than Japanese diabetics," Dr. Anderson said. He believes the reason is that Japanese diets are low in fat and cholesterol. He also noted that high-fat diets may contribute to obesity, the complicating problem in more than 75 percent of all adult diabetics.

Dr. Anderson was an early pioneer in getting physicians to begin encouraging their patients to eat more high-fiber, low-fat foods. When he began his crusade, the standard diabetic breakfast at hospitals was bacon, eggs, and high-protein foods. Dr. Anderson and his colleagues introduced the high-fiber and less-fat concept in America and abroad. He has experimented with a number of high complex-carbohydrate foods to prove his point. He believes that the average adult's diet should include at least 40 grams of fiber. "You can greatly increase your intake by substituting fiber-rich foods you already eat," he says, adding that whole-wheat bread, bran cereals, oats, beans, and most vegetables are good fiber sources.

Dr. Anderson also advises switching American meal that consists of meat as the primary food, with vegetables and bread as side dishes. Vegetables, salads, beans, breads, and fruits, he says, should be the primary dishes, with meat and fat as side dishes.
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Publication:Saturday Evening Post
Date:Jan 1, 1990
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